Provider Demographics
NPI:1720715543
Name:THERAPEUTIC ALTERNATIVES: TMS AND MEDICAL CANNABIS CENTER
Entity Type:Organization
Organization Name:THERAPEUTIC ALTERNATIVES: TMS AND MEDICAL CANNABIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:401-287-8810
Mailing Address - Street 1:3970 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-9235
Mailing Address - Country:US
Mailing Address - Phone:401-287-8810
Mailing Address - Fax:401-287-8847
Practice Address - Street 1:3970 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-9235
Practice Address - Country:US
Practice Address - Phone:401-287-8810
Practice Address - Fax:401-287-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty